1. RaySearch Laboratories (Sweden)
2. Centro Nazionale di Adroterapia Oncologica (Italy)
3. Sheffield Hallam University (UK)
In radiotherapy, patients are typically treated in supine position, with the arm of the linear accelerator rotating around the patients. The preparatory CT-scan (i.e. the planning CT) is thus performed in the same position as typically done for diagnostic imaging.
However, several recent studies suggested that patient positioning in an upright position (sitting or standing) could improve treatment delivery to some tumor locations. In pelvic tumors, in upright positioning, the bladder is more elongated in anterior posterior direction and the distance between the sacrum and the bladder is reduced, suggesting that the small bowel could be spared more efficiently during radiotherapy. In the thorax, it has been shown that the breathing motion and especially the cranio-caudal movement is significantly reduced, thus contributing to the generation of a much smaller PTV, thus allowing irradiation of less lung tissue. In head and neck tumor, on top of improved patient comfort, upright positioning could better separate the tumor volume from the posterior pharyngeal wall, thus contributing to lower dose delivery on the constrictor muscles, thus less radiation-induced dysphagia.
In this framework, the goal of the project is to demonstrate and quantitate the advantages and disadvantages of up-right radiotherapy patient positioning in comparison to the standard positioning for head and neck, lung and breast cancer patients. More specifically this project will focus on patient positioning set-up for patients with lung, breast and head and neck tumors.
Tasks:
I am Nkuebe Clement Moleko from Lesotho. I am currently working on UPLIFT Project #6: Clinical Upright Radiotherapy Workflow at a Photon Centre at the Centre de Lutte Contre le Cancer Léon Bérard, under the supervision of Prof. Vincent Grégoire, and I am registered with Université Claude Bernard Lyon 1.
My academic background spans physics, mathematics, and medical physics. I hold a double major in Mathematics and Physics from the National University of Lesotho, a Physics Honours degree from the University of the Witwatersrand and completed a two-year professional training programme in Medical Physics at the International Centre for Theoretical Physics (ICTP). I later obtained an MSc in Healthcare Technologies (Medical Imaging) from King’s College London.
My research focuses on translating the concept of upright radiotherapy into clinical practice. Using the Eve Marie® upright system from Leo Cancer Care, I will optimise patient positioning, evaluate setup accuracy and motion using a surface-guiding system, and assess patient comfort and satisfaction compared with conventional supine treatments.
I will acquire both upright and supine CT scans, design treatment plans in RayStation®, and compare dosimetric outcomes and inter- and intra-fraction motion, focusing on breast, lung, and prostate cancers. This work will culminate in the development of a standardised upright CT acquisition protocol.
Growing up in a country without a dedicated cancer hospital exposed me early to inequities in cancer care and shaped my commitment to studying radiotherapy. Personal experiences with cancer have further strengthened my resolve to develop patient-centred, clinically robust, and resource-efficient radiotherapy solutions. My project directly reflects this mission by enabling equitable, comfortable, and scalable treatment approaches.
Through UPLIFT, I look forward to collaborating with clinicians, engineers, industry partners, and fellow researchers while gaining cutting-edge skills to address one of the biggest healthcare challenges of our time: cancer. Outside work, I enjoy going to the gym, learning French, travelling and exploring new cultures.
Nkuebe Clement Moleko | LinkedIn
